Daugherty, John Thomas

Daugherty, John Thomas is an individual health care provider with primary practice located at 110 Executive Park Dr , Clinton TN 37716-6876. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Daugherty, John Thomas can be contacted via phone (865) 494-9241.

Contact Information

Primary practice address
110 Executive Park Dr Clinton TN 37716-6876
Phone: (865) 494-9241
Fax: (865) 494-2522
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD0000021373 Tennessee

Profile Details

NPI number 1306834122
LBN Legal business name Daugherty, John Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Jan 9th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306834122 NPPES
Tennessee Other 125762 BLUE CROSS
Tennessee Other 080030188 BLUE CROSS
Tennessee MEDICAID 3062410 BLUE CROSS

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